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Show us what reformed Medicaid looks like, governor

Press-Tribune Editorial board
March 28, 2013
Idaho Press-Tribune

Advocates for the poor are putting on a full-court press for Idaho lawmakers, urging them to expand Medicaid coverage so that more of the state’s low-income population get receive medical coverage. Given the chaos in the Legislature right now, that isn't likely to happen.

It's nearly April and tempers are frail, as evidenced by the spat between the House and Senate on three pieces of gun rights legislation and the education budget. So great is the animosity between both houses that all three gun measures have been shot down, and it's possible the session could be extended beyond Friday's planned adjournment to redesign the public schools budget.

This deep into legislative sessions, such rows aren't uncommon. So given that reality, it's probably just as well legislators don't rush through the testy subject of Medicaid expansion.

In a nutshell, here's the dilemma: Thousands of Idahoans without health coverage could get it if the state agrees to the expansion, paid for with federal funds. The Idaho Department of Health and Welfare, as one would expect, is urging expansion, saying it could mean nearly half a billion dollars in property tax relief for Idahoans.

But remember, Medicaid expansion is part of "Obamacare," fiercely opposed by conservative lawmakers. Gov. Butch Otter remains opposed to Medicaid expansion unless a "broken" system is reformed, and that would include more emphasis on patient responsibility.

Otter exhausted a lot of political capital this year with a strong push to convince skeptical Republicans to approve a state-based insurance exchange - another component of the Affordable Care Act. That effort alone shows the governor isn't an unbending ideologue, so his concerns deserve consideration.

We should all agree that more people should have health coverage. Too many poor people don't. The question has always been how best to provide it.

There are many reasons to be wary of Obamacare. It was supposed to lower costs, yet premiums and claim costs are increasing. It was supposed to cover more people, yet businesses are reducing their employees' work hours to under 30 because they can't afford to provide them the mandatory coverage.

Otter is rightfully concerned that Medicaid expansion could create a larger dependency on a federal government beating a furious path to bankruptcy. So he raises a legitimate point in wanting to get more Idahoans to take more ownership of their health.

Since the Legislature hasn't the appetite for another rigorous vetting of another contentious issue, Otter should use the rest of the year to consult with the task force he appointed on this issue and show the state what a reformed Medicaid system would look like. Give us specifics on how increased patient responsibility would work. He's going to have plenty of time. Let's see a plan.

It would be fantastic to cover more people and save property taxpayers money. But out-of-control spending is a valid concern. Idaho could be a beacon for the nation if it can produce a workable plan to address all of those concerns.

* Our view is based on the majority opinions of the Idaho Press-Tribune editorial board. Members of the board are Publisher Matt Davison, Managing Editor Vickie Holbrook, Opinion Editor Phil Bridges and community members Maria Radovich, Kenton Lee, Rich Cartney, Megan Harrison and Kelly Gibbons.

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The editorial posted here is provided by permission of its original publisher and does not necessarily reflect the views of Idaho Public Television.

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